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Table 3 Characteristics of the included studies

From: Impact of moral case deliberation in healthcare settings: a literature review

Reference number Authors Journal Title Country Setting and participants of the conversation Data collection and respondents Conversation method Type of case
28 Appelbaum & Reiser (1981) Hospital & Community Psychiatry Ethics rounds: a model for teaching ethics in the psychiatric setting USA Mental healthcare, multidisciplinary Quantitative: questionnaires among participants Presentation and discussion, no particular method mentioned Patient cases, retrospective (occasionally active)
30 Baumann-Hölzle, Maffezzoni & Bucher (2005) Acta Pædiatrica A framework for ethical decision making in neonatal intensive care Switzerland Hospital care (neonatal IC), multidisciplinary Quantitative: questionnaires among participants; survival comparison with controls Locally developed framework for structured decision making Patient cases, prospective
16 Bernthal, Russell & Draper (2014) Journal of the Royal Army Medical Corps A qualitative study of the use of the four quadrant approach to assist ethical decision-making during deployment United Kingdom Military hospital care, health professionals Qualitative: analysis of case conference forms; interviews with participants Four Quadrant Approach (4QA) Patient cases
33 Dauwerse, Weidema, Abma, Molewijk & Widdershoven (2014) HEC Forum Implicit and explicit clinical ethics support in The Netherlands: a mixed methods overview study The Netherlands, Norway Various settings, multidisciplinary Quantitative: surveys. Qualitative: interviews and focus groups with management and ethics support staff No particular method mentioned Not specified
27 De Boer, Van Blijderveen, Van Dijk, Duivenvoorden & Williams (2012) Journal of Medical Ethics Implementing structured, multiprofessional medical ethical decision-making in a neonatal intensive care unit The Netherlands Hospital care (neonatal IC), multidisciplinary Quantitative: questionnaires with staff Five-step procedure based on Utrecht model and Nijmegen method Patient cases, prospective (fictional cases when no actual case was at hand)
12 Grönlund, Dahlqvist, Zingmark, Sandlund & Söderberg (2016) HEC Forum Managing Ethical Difficulties in Healthcare: Communicating in Inter-professional Clinical Ethics Support Sessions Sweden “Highly specialized healthcare clinic”, multidisciplinary Qualitative: content-analysis of audio and video recorded ethics sessions Several steps, no particular method mentioned Patient cases
7 Janssens, Zadelhoff, Van Loo, Widdershoven & Molewijk (2016) Nursing Ethics Evaluation and perceived results of moral case deliberation: A mixed methods study The Netherlands, Norway Elderly care, multidisciplinary Quantitative and qualitative: questionnaires with participants; interviews; focus groups Dilemma method or Socratic dialogue Patient cases
13 Jehle & Jurchah (2014) Topics in Stroke Rehabilitation Patient With a Devastating Embolic Stroke: Using Weekly Multidisciplinary Ethics Rounds in the Neuroscience Intensive Care Unit to Facilitate Care and Communication USA Hospital care (neuroscience IC), multidisciplinary Quantitative: surveys, not specified “FESOR” format: Facts, Ethical question, Stakeholders, Options, Re-evaluation Patient cases
31 Levine, Scott & Curran (1977) Pediatrics Ethics rounds in a Children’s Medical Center: evaluation of a hospital-based program for continuing education in medical ethics USA Children’s hospital care, multidisciplinary Quantitative and qualitative: content-analysis of discussions; interviews and surveys among participants Presentation and discussion, no particular method mentioned Patient cases, retrospective
32 Lillemoen & Pedersen (2015) BMC Medical Ethics Ethics reflection groups in community health services: an evaluation study Norway Community health services, not clearly specified Qualitative: focus groups with 1) participants, 2) ethics facilitators and 3) service managers; content analysis of documentation and observations Centre for Medical Ethics method Patient cases; constructed cases
36 Maffezzoni, Wunder, Baumann-Hölzle & Stoll (2003) Zeitschrift für Arbeits- und Organisations-psychologie Gruppenprozesse bei Entscheidungen zur Levensfähigkeit von Neugeborenen – Eine formative Evaluation Switzerland Hospital care (neonatal IC), multidisciplinary Quantitative and qualitative: questionnaires among participants; analysis of video recorded sessions and conversation protocols Locally developed ethical decision-making model Patient cases, prospective
34 Meyer-Zehnder, Barandun Schäfer, Albisser Schleger, Reiter-Theil & Pargger (2014) Der Anaesthesist Ethische Fallbesprechungen auf der Intensivstation Vom Versuch zur Routine Switzerland Hospital care (IC), multidisciplinary Quantitative: questionnaires among participants; summary of conversation protocols “METAP” format: Module, Ethik, Therapieentscheidung, Allokation, Prozess Patient cases, prospective
4 Molewijk, Verkerk, Milius & Widdershoven (2008) Medicine, Health Care and Philosophy Implementing moral case deliberation in a psychiatric hospital: process and outcome The Netherlands Mental healthcare, multidisciplinary Quantitative and qualitative responsive evaluation: a questionnaire among participants; interviews with various stakeholders; participant observation; document analysis Structured conversation, no particular method mentioned Patient cases, retrospective and prospective
5 Molewijk, Abma, Stolper & Widdershoven (2008) Journal of Medical Ethics Teaching ethics in the clinic. The theory and practice of moral case deliberation The Netherlands Mental healthcare Responsive evaluation approach Depending on the case Patient cases, professional-centered issues, and organization-centered questions
18 Silén, Haglund, Hansson & Ramklint (2015) Nordic Journal of Psychiatry Ethics rounds do not improve the handling of ethical issues by psychiatric staff Sweden Mental healthcare, multidisciplinary Quasi-experimental: questionnaires in both intervention and control groups Approach of imaginative ethics, no particular method mentioned Patient case or theme
14 Silén, Ramklint, Hansson & Haglund (2016) Nursing Ethics Ethics rounds: An appreciated form of ethics support Sweden Mental healthcare, multidisciplinary Qualitative exploratory and descriptive design: interviews with participants Approach of imaginative ethics, no particular method mentioned Patient case or theme
17 Söderhamn, Kjøstvedt & Slettebø (2014) Nursing Ethics Evaluation of ethical reflections in community healthcare: A mixed-methods study Norway Community health services Qualitative and quantitative: focus groups with participants; questionnaires with employees Traffic light method and fishbowl method Ethical dilemmas
35 Svantesson, Anderzén-Carlsson, Thorsén, Kallenberg & Ahlström (2008) Journal of Medical Ethics Interprofessional ethics rounds concerning dialysis patients: staff’s ethical reflections before and after rounds Sweden Hospital care (nephrology), multidisciplinary Quantitative and qualitative: questionnaires; content analysis of open-ended questions Ethics rounds, no particular method mentioned Patient cases
29 Svantesson, Löfmark, Thorsén, Kallenberg & Ahlström (2008) Journal of Medical Ethics Learning a way through ethical problems: Swedish nurses’ and doctors’ experiences from one model of ethics rounds Sweden Hospital care (nephrology), multidisciplinary Qualitative: interviews with participants Ethics rounds, no particular method mentioned Patient cases
15 Tanner, Albisser Schleger, Meyer-Zehnder, Schnurrer, Reiter-Theil & Pargger (2014) Medizinische Klinik – Intensiv-medizin und Notfall-medizin Klinische Alltagsethik – Unterstützung im Umgang mit moralischem Disstress? Evaluation eines ethischen Entscheidungsfindungsmodellsfür interprofessionelle klinische Teams Switzerland Hospital care (IC and geriatrics), multidisciplinary Qualitative and quantitative: individual and group interviews with employees; questionnaires among employees “METAP” format: Module, Ethik, Therapieentscheidung, Allokation, Prozess Patient cases
8 Van der Dam, Abma, Molewijk, Kardol, Schols & Widdershoven (2011) Nursing Ethics Organizing moral case deliberation Experiences in two Dutch nursing homes The Netherlands Elderly care, multidisciplinary Qualitative: interviews with managers; observations and (tape) recordings of sessions; focus groups with participants Depending on the case Patient cases
9 Van der Dam, Schols, Kardol, Molewijk, Widdershoven & Abma (2013) Social Science & Medicine The discovery of deliberation. From ambiguity to appreciation through the learning process of doing Moral Case Deliberation in Dutch elderly care The Netherlands Elderly care, multidisciplinary Qualitative: interviews with managers and other stakeholders; observations and (tape) recordings of sessions; focus groups with participants Depending on the case Patient cases
26 Voskes, Evenblij, Noorthoorn, Porz & Widdershoven (2014) Psychiatrische Praxis Ethische Fall-Deliberation zu Freiheitseinschränkungen in der Psychiatrie. Dilemmata, Nutzen und Implementierung The Netherlands, Switzerland Mental healthcare, multidisciplinary Qualitative: interviews and focus groups with participants/employees; observation of sessions Dilemma method Patient cases, retrospective and prospective
6 Weidema, Molewijk, Kamsteeg & Widdershoven (2013) Nursing Ethics Aims and harvest of moral case deliberation The Netherlands Mental healthcare, mono-disciplinary (nurses) Qualitative and quantitative: interviews with managers; questionnaires with participants Structured conversation, no particular method mentioned Concrete work-based case
11 Wocial, Hancock, Bledsoe, Chamness & Helft (2010) JONA’S Healthcare Law, Ethics, and Regulation An evaluation of unit-based ethics conversations USA Hospital care (different nursing units), mono-disciplinary (nurses) Quantitative and qualitative: a survey among employees; focus group with participants Structured story-telling, no particular method mentioned Ethically challenging situations in care